Healthcare Provider Details

I. General information

NPI: 1992615868
Provider Name (Legal Business Name): NOVA HEALTH PUERTO RICO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CARR 2 KM 112.2
ISABELA PR
00662
US

IV. Provider business mailing address

PO BOX 484
ISABELA PR
00662-0484
US

V. Phone/Fax

Practice location:
  • Phone: 787-594-5784
  • Fax:
Mailing address:
  • Phone: 787-594-5784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LUIS R NIEVES SR.
Title or Position: MD
Credential: MD
Phone: 787-594-5784